Provider Demographics
NPI:1457442485
Name:SCOTT MILLIKEN, D.D.S., M.S., INC
Entity Type:Organization
Organization Name:SCOTT MILLIKEN, D.D.S., M.S., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WINFIELD
Authorized Official - Last Name:MILLIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:650-697-3450
Mailing Address - Street 1:1828 EL CAMINO REAL
Mailing Address - Street 2:505
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3103
Mailing Address - Country:US
Mailing Address - Phone:650-697-3450
Mailing Address - Fax:
Practice Address - Street 1:1828 EL CAMINO REAL
Practice Address - Street 2:505
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3103
Practice Address - Country:US
Practice Address - Phone:650-697-3450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35763 487971223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty